Unexplained Infertility

Unexplained infertility is diagnosed in 10–30% of infertile couples when semen analysis, ovarian reserve testing, fallopian tube assessment (HSG), and uterine evaluation are all within normal limits. It does not mean nothing is wrong — it means current tests are unable to identify the cause.

Potential undetected issues include subtle egg quality problems, sperm DNA fragmentation, endometrial receptivity defects, or immunological factors not captured by standard testing.

Treatment typically follows an empirical ladder: ovulation induction with timed intercourse → IUI with gonadotropins → IVF. IVF allows the embryologist to observe fertilization and embryo development, sometimes revealing previously hidden issues.